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TheScientificWorldJOURNAL
Volume 9 (2009), Pages 1119-1126
http://dx.doi.org/10.1100/tsw.2009.127
Review Article

Posterior Urethral Valves

Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC, USA

Received 29 December 2008; Revised 10 September 2009; Accepted 27 September 2009

Academic Editor: Barry Duel

Copyright © 2009 Steve J Hodges et al.

Abstract

The most common cause of lower urinary tract obstruction in male infants is posterior urethral valves. Although the incidence has remained stable, the neonatal mortality for this disorder has improved due to early diagnosis and intensive neonatal care, thanks in part to the widespread use of prenatal ultrasound evaluations. In fact, the most common reason for the diagnosis of posterior urethral valves presently is the evaluation of infants for prenatal hydronephrosis. Since these children are often diagnosed early, the urethral obstruction can be alleviated rapidly through catheter insertion and eventual surgery, and their metabolic derangements can be normalized without delay, avoiding preventable infant mortality. Of the children that survive, however, early diagnosis has not had much effect on their long-term prognosis, as 30% still develop renal insufficiency before adolescence. A better understanding of the exact cause of the congenital obstruction of the male posterior urethra, prevention of postnatal bladder and renal injury, and the development of safe methods to treat urethral obstruction prenatally (and thereby avoiding the bladder and renal damage due to obstructive uropathy) are the goals for the care of children with posterior urethral valves[1].